Manager of Quality Improvement - RN preferred

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

Provides management of quality improvement program as a core service to Community & State Plans. The Director works within highly matrixed relationships to insure full implementation of the quality improvement program, insuring the program is proactive, applies to all product and programs within the state, and drives to continuously improving gaps in care closure and HEDIS to meet the needs of the member and the plan. The quality improvement director actively supports the RFP responses. This position develops and maintains strong relationships with state regulators as applicable. This position collaborates with multiple functions that may include Clinical, Physician Engagement, Member Experience, Benefit Design/Product, Compliance, Network, Behavioral Services, and Pharmacy as needed to drive the quality management program.

Primary Responsibilities:

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  Oversees the implementation of plan quality improvement program


• Works to coordinate the work within the QMP Centers of Excellence in order to improve HEDIS performance and to close gaps in care


• Manages Playbook or work plan programs and activities


• Collaborates across business segments to achieve goals and targets


• Develops and maintains positive relationships external state organizations within the scope of Quality Improvement


• Helps insures the creation, integration, maintenance, approval of the quality improvement Playbooks or work plans


• Continuously monitors HEDIS interim results and adjust programs to insure meeting targeted goals


• Supports PIPS, accreditation, and regulatory audits as needed


• Interviews, hires, and supervises quality department staff


• Develops, mentors, and coaches staff

Required Qualifications:

• BS/BA/BSN in related field


• 5+ years of experience in leading an integrated and progressive quality organization, preferably within health care industry


• 5+ years managerial experience


• 5+ years of experience with demonstrated functional knowledge of process improvement, quality improvement, and change management


• Proficiency with Microsoft Office Suite to include Word, Outlook and Excel


• Knowledgeable of HEDIS

Preferred Qualifications: 

• Master's degree or higher


• Unrestricted and active RN license


• Knowledgeable of the managed care/health insurance industry, products and services

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.